Management of Patients with Metastatic Bladder Cancer in the Real-World Setting from the Multidisciplinary Team: Current Opinion of the SOGUG Multidisciplinary Working Group.

Based on the discussion of current state of research of relevant topics of metastatic bladder cancer (mBC) among a group of experts of a Spanish Oncology Genitourinary (SOGUG) Working Group, a set of recommendations were proposed to overcome the challenges posed by the management of mBC in clinical practice. First-line options in unfit patients for cisplatin are chemotherapy with carboplatin and immunotherapy in PD-L1 positive patients. FDG-PET/CT may be a useful imaging technique in the initial staging or re-staging. In patients with oligometastatic disease, it is important to consider not only the number of metastatic lesions, but also the tumor biology and the clinical course. The combination of stereotactic body radiotherapy and immunotherapy with anti-PD-L1 monoclonal antibodies is under investigation and could improve the results of systemic treatment in patient with oligometastatic disease. Rescue treatment with curative intent could be considered in patients with oligometastatic disease after complete response on FDG-PET/CT. Metastatic disease should be evaluated using the same imaging modality over the course of the disease from diagnosis until rescue treatment. For improving the outcome of patients with mBC, the involvement of a dedicated multidisciplinary team, including urologists, pathologists, oncologists, radiologists and other specialists is of outmost importance in the daily care of these patients.

Cancers. 2022 Feb 23*** epublish ***

Aránzazu González-Del-Alba, Antonio José Conde-Moreno, Ana M García Vicente, Pilar González-Peramato, Estefanía Linares-Espinós, Miguel Ángel Climent

Department of Medical Oncology, Puerta de Hierro-Majadahonda University Hospital, Joaquin Rodrigo 1, Majadahonda, 28222 Madrid, Spain., Department of Radiation Oncology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain., Nuclear Medicine Department, University General Hospital, 13005 Ciudad Real, Spain., Department of Pathology, University Hospital La Paz, Universidad Autónoma de Madrid, 28046 Madrid, Spain., Deparment of Urology, University Hospital La Paz, Universidad Autónoma de Madrid, 28046 Madrid, Spain., Medical Oncology Service, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain.

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